Mania

Mania seems to be one aspect of bipolar that is both the best understood and the most misunderstood generally.  It is generally understood that mania is a strong indicator of bipolar, however it is misunderstood that all people with bipolar experience mania.  For example, to the best of my knowledge, I have not experienced mania.  This makes me less qualified to write a post on this topic.  However, since it would be remiss of me to discuss depression and bipolar without mania, here is a post drawn mostly from the literature.

Recognizing Mania
This description from the DSM IV is an objective description of mania which might be different from the subjective experience of it.

A) A distinct period of abnormally and persistently elevated, expansive or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary)
B) During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:

1. inflated self-esteem or grandiosity
2. decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
3. more talkative than usual or pressure to keep talking
4. flight of ideas or subjective experience that thoughts are racing
5. distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
6. increase in goal-directed activity (at work, at school, or sexually) or psychomotor agitation
7. excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

C) The symptoms do not meet criteria for a Mixed Episode

D) The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.

E) The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication or other treatment) or a general medical condition (e.g., hyperthyroidism)

It seems to me that mania is difficult to recognize without having repeated experiences with it.  Even when I saw mania in a close friend I had difficulty discerning their lack of judgement and impulsiveness.

Preventing and Treating Mania
Mania should be treated together with whatever other bipolar symptoms that one has.  This is typically done using drugs such as Lithium that act as a mood stabilizer.

It is not sufficient to treat mania only with drugs, as therapy and support from family and friends also plays a large role.  In this it is best if the person with bipolar takes charge, as attempts to force the person to comply will likely destroy the very trust needed for success.  One should try to identify triggers as much as possible and make contingency plans for future episodes. Involving family in contingency plans can help with determining when the family can make decisions on the behalf of the person with bipolar and when support is wanted or needed.  Or perhaps the person with bipolar might request for a family member to have control over their finances with a mutually agreed upon allowance, and with mutually agreed upon ability to revise the agreement.

These sorts of plans and frank conversations help prevent misunderstandings such as relatives refusing to make a monetary loan to a stable person because they mistakenly believe the request is a symptom of mania.  Or an even more harmful misunderstanding, relatives may unilaterally decide when a person with bipolar should be involuntarily hospitalized.  Planning helps with decide the conditions under which a person will voluntarily be hospitalized or when they might wish to request decision making help from certain trusted relatives.